COVID-19 is impacting the U.S. healthcare system in unprecedented and complex ways. Some segments of the healthcare system are responding to a surge of patients with COVID-19 and experiencing higher costs. Other sectors of the healthcare system are seeing a different impact: fewer patients seeking care due to social distancing and limits on elective procedures. A new blog from the National Association of Medicaid Directors (NAMD) explores early insights from Medicaid leaders on healthcare utilization during COVID-19 and lays out the questions Medicaid directors are still trying to answer. The blog post notes two items that involve FQHCs:

• Social distancing and the closure or limited capacities of outpatient practices reduced Medicaid service use in many categories in March and April, including primary care services at federally qualified health centers. Depending on the state and service category, declines ranged anywhere from 10 to 90 percent.
• Service utilization may be slowly increasing. A few states are seeing an uptick in service use, which may be the result of more telehealth adoption, as well as easing of social distancing measures and increased access to personal protective equipment for providers. For example, one state saw an uptick in primary care services at community health centers, likely because of telehealth adoption.

The full blog post is available here.

Even before the term COVID-19 had entered our vocabulary, burnout, stress and anxiety were significant issues in the workplace, and society generally. Throw the pandemic’s mental health impact into the mix, and work-related stress is likely to reach staggering levels in the coming months.

• The economy is now a significant source of stress for 70% of Americans
• The government’s response to the crisis is causing stress in 67% of Americans
• More than 1/3 of Americans have displayed clinical signs of anxiety, depression or both since the pandemic began
• Only 50% of employers are comfortable discussing mental health issues
• Nearly one in five Americans say they have a physical reaction when thinking about the outbreak
• In a March Pew study, 18% said they had experienced nervousness or anxiety most or all of the time during the past week
• Text messages to a SAMHSA disaster distress hotline increased more than 1000% last month
• Mental health is poorest among those unemployed for six months or more
• The long-term psychological consequences of collective traumas can last a decade or more
• Pandemic stress is significantly higher in young people

Read more.

The Pennsylvania Department of Health (DOH) issued these Health Alerts this week related to the COVID-19 pandemic:

• 510 – 06-01-UPD: Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19. This guidance has been updated to simplify the determination of risk exposures warranting work restriction.
• 509 – 5-29-UPD: Testing Guidance for COVID-19 in Long-term Care Facilities Residents and Healthcare Personnel: This version of PA-HAN-509 has been updated to reflect a correction to the email address for DOH licensed facilities to request support for COVID-19 testing: RADHCOVIDTESTING@pa.gov.

Visit the DOH 2020 Health Alerts, Advisories and Updates website for the most recent information.

The Department of Health (DOH) has revised their healthcare community guidance to reflect Gov. Wolf’s strategic phased reopening plan and align with current clinical best practices, particularly related to performing non-urgent dental procedures. With dental having unique characteristics that warrant specific infection control considerations, the Governor and Secretary of Health have revised their business closure orders issued on March 19, 2020 and have removed the prohibition on non-urgent and non-emergent dental procedures. All Centers for Disease Control & Prevention (CDC) guidelines will need to be adhered to and it is still up to the professional judgment of the health center’s dental clinicians to determine just what procedures will be performed. Read the entire updated Pennsylvania guidance. PACHC will continue to monitor for updates that may impact health center dental operations.

Although not quite as bad as April, Pennsylvania’s revenue collections were nearly $440 million below estimate, pushing the commonwealth’s current revenue shortfall to $2.6 billion. While May did see some loosening of Pennsylvania’s COVID-19 restrictions, the month’s General Fund revenues were still $439.7 million, or 17.3 percent, less than anticipated, leaving the year-to-date General Fund revenue total $2.6 billion short of estimate, according to a report on Monday from the Department of Revenue.

HRSA has updated the Find a Health Center tool to allow users to filter for health center sites that offer COVID-19 testing. In addition to displaying all health centers, users can now see only those with testing. Visit the site to see if your health center’s COVID-19 capabilities are accurately reflected. If you have questions or need the information for your FQHC, contact Amanda Tekely, PACHC’s Events and Communications Manager.

CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

Call details are below. Conference lines are limited so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. You are welcome to share this invitation with your colleagues and professional networks. These calls are not intended for the press.

Calls recordings and transcripts are posted on the CMS podcast page at: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts

CMS COVID-19 Office Hours Calls (Tuesdays at 5:00 – 6:00 PM Eastern)

Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:

• Increase Hospital Capacity – CMS Hospitals Without Walls;
• Rapidly Expand the Healthcare Workforce;
• Put Patients Over Paperwork; and
• Further Promote Telehealth in Medicare

This week’s Office Hours:

Tuesday, June 9^th at 5:00 – 6:00 PM Eastern

Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 4892554

Audio Webcast link: https://protect2.fireeye.com/url?k=6b9f9bee-37cbb2c5-6b9faad1-0cc47a6d17cc-71d1a27a3efd1e66&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2171

Weekly COVID-19 Care Site-Specific Calls

CMS hosts weekly calls for certain types of organizations to provide targeted updates on the agency’s latest COVID-19 guidance. One to two leaders in the field also share best practices with their peers. There is an opportunity to ask questions of presenters if time allows.

Home Health and Hospice (Tuesdays at 3:00 PM Eastern)

Tuesday, June 9^th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 7359947 Audio Webcast Link: https://protect2.fireeye.com/url?k=00232b73-5c770258-00231a4c-0cc47a6d17cc-31afca23fe25ca11&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2160

Nursing Homes (Wednesdays at 4:30 PM Eastern)

Wednesday, June 10^th at 4:30 – 5:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 9782909 Audio Webcast Link: https://protect2.fireeye.com/url?k=9b60f2d6-c735fbc5-9b60c3e9-0cc47adb5650-5cc8b6ca21a0bb55&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2215

Dialysis Organizations (Wednesdays at 5:30 PM Eastern)

Wednesday, June 10^th at 5:30 – 6:00 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 6553907 Audio Webcast Link: https://protect2.fireeye.com/url?k=cb8280fa-97d69986-cb82b1c5-0cc47adc5fa2-2ac51b79b83598dd&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2225

Nurses (Thursdays at 3:00 PM Eastern)

Thursday, June 11^th at 3:00 – 3:30 PM Eastern

Toll Free Attendee Dial-In: 833-614-0820; Access Passcode: 2863547 Audio Webcast Link: https://protect2.fireeye.com/url?k=842afbda-d87ff2c9-842acae5-0cc47adb5650-f3419d0fb8afb1c7&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=2231

To keep up with the important work the White House Task Force is doing in response to COVID-19 click here: https://protect2.fireeye.com/url?k=36fa2226-6aae0b0d-36fa1319-0cc47a6d17cc-2d06c219f858d641&u=http://www.coronavirus.gov/. For information specific to CMS, please visit the Current Emergencies Website.